Summary about Disease
Vocal Cord Dysfunction (VCD), also known as paradoxical vocal fold movement (PVFM), is a condition where the vocal cords close or narrow when you breathe in or out, even when there's no physical blockage. This abnormal movement obstructs airflow, leading to breathing difficulties, and mimicking asthma or other respiratory issues. It's not an anatomical problem with the vocal cords themselves, but rather a malfunction in their movement.
Symptoms
Difficulty breathing, especially when inhaling (stridor).
Wheezing or a high-pitched whistling sound when breathing.
Chest tightness.
Coughing.
Throat tightness or pain.
Hoarseness or voice changes.
A feeling of choking or suffocation.
Frequent clearing of the throat.
Symptoms often come on suddenly and resolve quickly.
Symptoms are often triggered by irritants, exercise, or stress.
Causes
The exact cause of VCD is often unknown, but several triggers can contribute:
Irritants: Exposure to fumes, smoke, strong odors, allergies, post-nasal drip, or gastroesophageal reflux disease (GERD).
Exercise: Strenuous physical activity, especially in cold or dry air.
Stress: Emotional stress, anxiety, or psychological factors.
Neurological conditions: Rarely, underlying nerve or muscle disorders.
Upper respiratory infections: Colds or the flu.
Idiopathic: In some cases, no identifiable trigger is found.
Medicine Used
Medications aren't typically the primary treatment for VCD, as the condition involves abnormal vocal cord movement rather than inflammation or infection. However, medications may be used to manage underlying conditions that trigger VCD:
GERD Medications: Proton pump inhibitors (PPIs) or H2 blockers to reduce stomach acid reflux.
Allergy Medications: Antihistamines or nasal corticosteroids to control allergy symptoms.
Anti-anxiety Medications: In some cases, medications to manage anxiety or panic disorders may be considered.
Muscle Relaxants: Rarely, in severe cases, muscle relaxants may be considered on a short-term basis. The most effective treatment involves speech therapy and breathing techniques, not medication.
Is Communicable
No, Vocal Cord Dysfunction is not a communicable disease. It is not caused by an infectious agent and cannot be transmitted from person to person.
Precautions
Identify and avoid triggers: Keep a diary to track when symptoms occur and what might have triggered them.
Manage underlying conditions: Treat GERD, allergies, or asthma effectively.
Practice relaxation techniques: Use deep breathing exercises, meditation, or yoga to manage stress.
Avoid irritants: Limit exposure to smoke, fumes, and strong odors.
Stay hydrated: Drink plenty of water to keep the vocal cords lubricated.
Warm up before exercise: Gradually increase intensity during physical activity.
How long does an outbreak last?
An episode of VCD can last from a few seconds to several minutes. Between episodes, breathing is usually normal. The frequency and severity of outbreaks vary from person to person.
How is it diagnosed?
Diagnosis of VCD usually involves:
Medical history and physical exam: The doctor will ask about your symptoms and medical history.
Laryngoscopy: A small, flexible scope is inserted through the nose or mouth to visualize the vocal cords during breathing. This is the most definitive diagnostic test.
Pulmonary function tests (PFTs): These tests measure how well your lungs are working. PFTs can help rule out asthma but may be normal or show unusual patterns in VCD.
Ruling out other conditions: The doctor will exclude asthma, allergies, and other respiratory problems.
Timeline of Symptoms
Sudden Onset: Symptoms often appear abruptly, sometimes triggered by a specific event (e.g., exposure to an irritant, exercise).
Rapid Peak: Symptoms quickly reach their most intense point within seconds or minutes.
Short Duration: Episodes typically last for a few seconds to several minutes.
Rapid Resolution: Symptoms usually subside relatively quickly once the trigger is removed or breathing techniques are used.
Variable Frequency: The frequency of episodes varies widely between individuals. Some may experience them daily, while others may have them only occasionally.
Important Considerations
Misdiagnosis: VCD is often misdiagnosed as asthma, leading to unnecessary treatments.
Psychological impact: The sudden onset of breathing difficulties can be frightening and lead to anxiety or panic.
Speech therapy: Speech therapy focusing on breathing techniques is a key component of management.
Multidisciplinary approach: Treatment often involves collaboration between a physician (pulmonologist or otolaryngologist), speech-language pathologist, and mental health professional.
Education: Understanding VCD and its triggers is crucial for self-management.